scholarly journals The Impact of the Private Sector Co-Payment Mechanism (PSCM) on the Private Market for ACTs in Nigeria: Results of the 2018 Cross-sectional Outlet and Household Market Surveys.

2021 ◽  
Author(s):  
Hannah M. Edwards ◽  
Rubaiyath Sarwar ◽  
Parvez Mahmud ◽  
Shekarau Emmanuel ◽  
Kolawole Maxwell ◽  
...  
Keyword(s):  
Private Sector ◽  
Market Share ◽  
Market Competition ◽  
Household Survey ◽  
Green Leaf ◽  
Cross Sectional ◽  
Payment Mechanism ◽  
The Cost ◽  
The Impact ◽  
Over Time

Abstract BackgroundThe private sector plays a large role in malaria treatment provision in Nigeria. To improve access to, and affordability of, quality-assured artemisinin combination therapies (QA-ACTs) within this sector, the Affordable Medicines Facility - Malaria began operations in 2010 and transitioned to a private sector co-payment mechanism (PSCM) until 2017. To assess the impact of the scheme on the ACT market, cross-sectional household and outlet surveys were conducted in 2018 to coincide with the final stockages of ACTs procured under the PSCM. MethodsAn outlet survey was conducted targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability and cost of antimalarials, including ACTs subsidised under the PSCM (called green leaf ACTs on account of their green leaf logo) and those not subsidised (non-green leaf ACTs). A concurrent household survey was conducted to determine demand-side factors related to treatment seeking practices, ACT brand preference and purchase decision. Data were compared with previous ACTWatch surveys to consider change over time.ResultsAvailability of ACTs increased significantly over the PSCM period and was almost universal by the time of the 2018 market survey. This increase was seen particularly among PPMVs. While the cost of green leaf ACTs remained relatively stable over time, the cost of non-green leaf ACTs reduced significantly so that by 2018 they had equivalent affordability. Unsubsidised brands were also available in different formulations and dosages, with double-strength ACTs reported as the most frequently purchased dosage type, and child ACTs popular in suspension and dispersible forms (forms not subsidised by the PSCM).ConclusionsThe PSCM had a clear impact on increasing not only the reach of subsidised QA brands, but also of non-subsidised brands. Increased market competition led to innovation from unsubsidised brands and large reductions in costs to make them competitive with subsidised brands. Concerns are drawn from the large market share that non-QA brands have managed to gain as well as the continued market share of oral artemisinin monotherapies. Continued monitoring of the market is recommended, along with improved local capacity for QA-certification and monitoring.

Brand awareness: revisiting an old metric for a new world

2017 ◽  
Vol 26 (5) ◽  
pp. 469-476 ◽  
Author(s):  
Jenni Romaniuk ◽  
Samuel Wight ◽  
Margaret Faulkner
Keyword(s):  
Market Share ◽  
Brand Management ◽  
Brand Awareness ◽  
Underlying Structure ◽  
Cross Sectional ◽  
Content Type ◽  
Country Level ◽  
Global Brand ◽  
The Impact ◽  
Over Time

Purpose Brand awareness is a pivotal, but often neglected, aspect of consumer-based brand equity. This paper revisits brand awareness measures in the context of global brand management. Design/methodology/approach Drawing on the method of Laurent et al. (1995), this cross-sectional longitudinal study examines changes in brand awareness over time, with sample sizes of approximately 300 whisky consumers per wave in three countries: United Kingdom, Taiwan and Greece. Findings There is consistency in the underlying structure of awareness scores across countries, and over time, extending the work of Laurent et al. (1995). Results show that a relevant operationalisation of brand awareness needs to account for the history of the brand. Furthermore, the nature of the variation of brand awareness over time interacts with a brand’s market share. Research limitations/implications When modelling the impact of brand awareness researchers need to consider two factors – the brand’s market share and whether a more stable or volatile measure is sought. This avoids mis-specifying the country-level contribution of brand awareness. Practical implications Global brand managers should be wary of adopting a “one size fits all” approach. The choice of brand awareness measure depends on the brand’s market share, and the desire for higher sensitivity or stability. Originality/value The paper provides one of the few multi-country investigations into brand awareness that can help inform global brand management.

scholarly journals Characteristics of those most vulnerable to employment changes during the COVID-19 pandemic: a nationally representative cross-sectional study in Wales

2021 ◽  
pp. jech-2020-216030
Author(s):  
Benjamin J Gray ◽  
Richard G Kyle ◽  
Jiao Song ◽  
Alisha R Davies
Keyword(s):  
Multinomial Logistic Regression ◽  
Household Survey ◽  
Well Being ◽  
Employment Outcomes ◽  
Cross Sectional Study ◽  
Public Health Response ◽  
Cross Sectional ◽  
Exact Test ◽  
Nationally Representative ◽  
The Impact

BackgroundThe public health response to the SARS-CoV-2 (COVID-19) pandemic has had a detrimental impact on employment and there are concerns the impact may be greatest among the most vulnerable. We examined the characteristics of those who experienced changes in employment status during the early months of the pandemic.MethodsData were collected from a cross-sectional, nationally representative household survey of the working age population (18–64 years) in Wales in May/June 2020 (n=1379). We looked at changes in employment and being placed on furlough since February 2020 across demographics, contract type, job skill level, health status and household factors. χ2 or Fisher’s exact test and multinomial logistic regression models examined associations between demographics, subgroups and employment outcomes.ResultsOf our respondents, 91.0% remained in the same job in May/June 2020 as they were in February 2020, 5.7% were now in a new job and 3.3% experienced unemployment. In addition, 24% of our respondents reported being placed on furlough. Non-permanent contract types, individuals who reported low mental well-being and household financial difficulties were all significant factors in experiencing unemployment. Being placed on ‘furlough’ was more likely in younger (18–29 years) and older (60–64 years) workers, those in lower skilled jobs and from households with less financial security.ConclusionA number of vulnerable population groups were observed to experience detrimental employment outcomes during the initial stage of the COVID-19 pandemic. Targeted support is needed to mitigate against both the direct impacts on employment, and indirect impacts on financial insecurity and health.

Health, Longevity, and Welfare Inequality of Older Americans

2021 ◽  
pp. 1-45
Author(s):  
Ray Miller ◽  
Neha Bairoliya
Keyword(s):  
Expected Utility ◽  
Well Being ◽  
Poor Health ◽  
Cost Of Living ◽  
Cross Sectional ◽  
Older Americans ◽  
The Cost ◽  
Welfare Inequality ◽  
Health And Mortality ◽  
Over Time

Abstract We estimate the distribution of well-being among the older U.S. population using an expected utility framework that incorporates differences in consumption, leisure, health, and mortality. We find large disparities in welfare that have increased over time. Incorporating the cost of living with poor health into elderly welfare substantially increases the overall inequality. Disparity measures based on cross-sectional income or consumption underestimate the growth in aggregate welfare inequality. Moreover, health is a better indicator of an individual's relative welfare position than income or consumption.

scholarly journals Modelling of the Impact of National Standardization on Duopolistic Competition in the Civil Aircraft Market

2020 ◽  
Vol 17 (4) ◽  
pp. 859-873
Author(s):  
E. V. Varyukhina ◽  
◽  
V. V. Klochkov ◽  
Keyword(s):  
Market Competition ◽  
Civil Aviation ◽  
Aviation Industry ◽  
Equilibrium Degree ◽  
Aviation Noise ◽  
Market Shares ◽  
Civil Aircraft ◽  
Zero Sum ◽  
The Cost ◽  
The Impact

The purpose of this study is to analyze standards as one of the main tools of protectionism in global markets of industrial goods. We use standards for modeling of market competition and adapt this approach for civil aviation markets. The role of local noise standards in civil aircraft markets is discussed. Imposition of more stringent aviation noise standards is modelled in the form of a two-person non-zero-sum game. Players are aircraft corporations that conduct research and development to reduce noise and lobby for stricter regulations in their controlled markets. The model can be used to predict that tighter aviation noise standards will be imposed and to justify the strategy of Russian aviation industry and science. The proposed approach can be adapted for other industries with strict regulations (in terms of safety, ecology). Such estimation allows us to assess whether it is in the country’s interests to participate in the standards race or not. It is shown that the equilibrium degree of standards tightening is higher if the players’ market shares are close to equal or individual players have advantages in the cost of production and/or product improvement is highly likely due to the company’s R&D progress.

scholarly journals Depression, Anxiety, Stress, and Associated Factors among Khat Chewers in Amhara Region, Northwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Seyfe Asrade Atnafie ◽  
Niguse Yigzaw Muluneh ◽  
Kefyalew Ayalew Getahun ◽  
Asegedech Tsegaw Woredekal ◽  
Wubayehu Kahaliw
Keyword(s):  
Substance Use ◽  
Chronic Illness ◽  
Private Sector ◽  
Associated Factors ◽  
Amhara Region ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Khat Chewing ◽  
Prevalence Of Depression ◽  
The Impact

Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem.

scholarly journals A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies

2020 ◽  
Vol 35 (6) ◽  
pp. 979-986 ◽  
Author(s):  
Arjan van der Tol ◽  
Vianda S Stel ◽  
Kitty J Jager ◽  
Norbert Lameire ◽  
Rachael L Morton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Home Dialysis ◽  
Kidney Replacement Therapy ◽  
The Cost ◽  
The Impact

Abstract Background We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. Methods This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data. Results The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P &lt; 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P &lt; 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P &lt; 0.001). Conclusions In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.

scholarly journals Impact of 123I-MIBG Scintigraphy on Clinical Decision-Making in Pheochromocytoma and Paraganglioma

2019 ◽  
Vol 104 (9) ◽  
pp. 3812-3820 ◽  
Author(s):  
Dipti Rao ◽  
Anouk van Berkel ◽  
Ianthe Piscaer ◽  
William F Young ◽  
Lucinda Gruber ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Diagnostic Value ◽  
Mibg Scintigraphy ◽  
Cross Sectional ◽  
First Choice ◽  
Cross Sectional Imaging ◽  
The Cost ◽  
The Impact

Abstract Context Cross-sectional imaging with CT or MRI is regarded as a first-choice modality for tumor localization in patients with pheochromocytoma and paraganglioma (PPGL). 123I-labeled metaiodobenzylguanidine (123I-MIBG) is widely used for functional imaging but the added diagnostic value is controversial. Objective To establish the virtual impact of adding 123I-MIBG scintigraphy to CT or MRI on diagnosis and treatment of PPGL. Design International multicenter retrospective study. Intervention None. Patients Two hundred thirty-six unilateral adrenal, 18 bilateral adrenal, 48 unifocal extra-adrenal, 12 multifocal, and 26 metastatic PPGL. Main Outcome Measures Patients underwent both anatomical imaging (CT and/or MRI) and 123I-MIBG scintigraphy. Local imaging reports were analyzed centrally by two independent observers who were blinded to the diagnosis. Imaging-based diagnoses determined by CT/MRI only, 123I-MIBG only, and CT/MRI combined with 123I-MIBG scintigraphy were compared with the correct diagnoses. Results The rates of correct imaging-based diagnoses determined by CT/MRI only versus CT/MRI plus 123I-MIBG scintigraphy were similar: 89.4 versus 88.8%, respectively (P = 0.50). Adding 123I-MIBG scintigraphy to CT/MRI resulted in a correct change in the imaging-based diagnosis and ensuing virtual treatment in four cases (1.2%: two metastatic instead of nonmetastatic, one multifocal instead of single, one unilateral instead of bilateral adrenal) at the cost of an incorrect change in seven cases (2.1%: four metastatic instead of nonmetastatic, two multifocal instead of unifocal and one bilateral instead of unilateral adrenal). Conclusions For the initial localization of PPGL, the addition of 123I-MIBG scintigraphy to CT/MRI rarely improves the diagnostic accuracy at the cost of incorrect interpretation in others, even when 123I-MIBG scintigraphy is restricted to patients who are at risk for metastatic disease. In this setting, the impact of 123I-MIBG scintigraphy on clinical decision-making appears very limited.

scholarly journals The Impact of New Drug Launches on Hospitalization in 2015 for 67 Medical Conditions in 15 OECD Countries: A Two-Way Fixed-Effects Analysis

2018 ◽  
Vol 21 (2) ◽  
Author(s):  
Frank R. Lichtenberg
Keyword(s):  
Prescription Drug ◽  
Fixed Effects ◽  
Medical Costs ◽  
Oecd Countries ◽  
Pharmaceutical Innovation ◽  
Cost Offset ◽  
The Cost ◽  
Cost Offsets ◽  
The Impact ◽  
Over Time

Abstract There are two types of prescription drug cost offsets. The first type of cost offset – from prescription drug use – is primarily about the effect of changes in drug quantity (e.g. due to changes in out-of-pocket drug costs) on other medical costs. Previous studies indicate that the cost offsets from prescription drug use may slightly exceed the cost of the drugs themselves. The second type of cost offset – the cost offset from prescription drug innovation – is primarily about the effect of prescription drug quality on other medical costs. Two previous studies (of a single disease or a single country) found that pharmaceutical innovation reduced hospitalization, and that the reduction in hospital cost from the use of newer drugs was considerably greater than the innovation-induced increase in pharmaceutical expenditure. In this study, we reexamine the impact that pharmaceutical innovation has had on hospitalization, employing a different type of 2-way fixed effects research design. In lieu of analyzing different countries over time for a single disease, or different diseases over time for a single country, we estimate the impact that new drug launches that occurred during the period 1982–2015 had on hospitalization in 2015 for 67 diseases in 15 OECD countries. Our models include both country fixed effects and disease fixed effects, which control for the average propensity of people to be hospitalized in each country and from each disease. The number of hospital discharges and days of care in 2015 is significantly inversely related to the number of drugs launched during 1982–2005, but not significantly related to the number of drugs launched after 2005. (Utilization of drugs during the first few years after they are launched is relatively low, and drugs for chronic conditions may have to be consumed for several years to achieve full effectiveness.) The estimates imply that, if no new drugs had been launched after 1981, total days of care in 2015 would have been 163% higher than it actually was. The estimated reduction in 2015 hospital expenditure that may be attributable to post-1981 drug launches was 5.3 times as large as 2015 expenditure on those drugs.

scholarly journals Association between cognitive phenotype in unaffected siblings and prospective 3- and 6-year clinical outcome in their proband affected by psychosis

2020 ◽  
pp. 1-11
Author(s):  
Thijs J. Burger ◽  
Frederike Schirmbeck ◽  
Jentien M. Vermeulen ◽  
Piotr J. Quee ◽  
Mariken B. de Koning ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Psychotic Disorders ◽  
Cognitive Vulnerability ◽  
Familial Risk ◽  
Related Factors ◽  
Cross Sectional ◽  
The Impact ◽  
Cognitive Alterations ◽  
Over Time

Abstract Background Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. Methods In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes (‘normal’, ‘mixed’ and ‘impaired’) in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. Results Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. Conclusions Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.

Rank and File Employee Satisfaction and the Implied Cost of Equity Capital

2020 ◽  
pp. 0148558X2097194
Author(s):  
Jiajia Fu ◽  
Yuan Ji ◽  
Jiao Jing
Keyword(s):  
Employee Satisfaction ◽  
Market Competition ◽  
Equity Capital ◽  
Cost Of Equity Capital ◽  
Cost Of Equity ◽  
Data Set ◽  
Financing Cost ◽  
The Cost ◽  
Market Benefits ◽  
The Impact

Rank and file employees execute firms’ daily operating activities, but prior research rarely examines their importance due to a lack of employee information. In this article, we use a novel data set—company reviews by rank and file employees—to provide evidence on the impact of employee satisfaction on a firm’s cost of equity capital. We find that firms with higher employee satisfaction have a lower cost of equity. Our results are robust to a variety of endogeneity tests and model specifications. We also find that the effect of employee satisfaction is more pronounced for firms with higher risk, greater financial constraints, and higher labor intensity or product market competition where labor is more critical to firm success. Further analysis shows that the negative association between employee satisfaction and the cost of equity is primarily grounded in reviews from current rather than former employees. Finally, we document that firms with high employee satisfaction experience lower systematic and idiosyncratic risk. Overall, our article presents novel evidence on the capital market benefits of higher employee satisfaction, particularly with regard to financing cost reduction.

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